Demographic and Clinical Characteristics of an MS and NMO Registry Cohort in Ghana
Fiifi Duodu1, Nana Boakye Agyeman Badu-Prempeh2, Prince Pekyi-Boateng3, Ruth Agyekum4, Albert Akpalu5, Deanna Saylor6
1Korle-Bu Teaching Hospital Medical department, 2Johns Hopkins Bloomberg School of Public health, 3University Of Utah Health, 4Johns Hopkins School of public health, 5School of Medicine and Dentistry, 6Johns Hopkins Hospital
Objective:
To describe the demographic and clinical characteristics of patients with MS and NMO/NMOSD at a tertiary hospital in Ghana.
Background:
There is limited epidemiological data on Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO) in sub-Saharan Africa.

 

Design/Methods:
This retrospective study was conducted at a tertiary hospital in Ghana from April 2022 to August 2024.
Results:
A total of 51 patients were included: 34 (66.7%) with MS and 17 with NMO
/NMOSD. Among MS patients, 62% were female, with an average age of 34.0 years.  97% were of African ancestry. 97% had relapsing-remitting MS. The average time from symptom onset to diagnosis was 4.8 years. Optic neuritis (41.2%) was the most common initial symptom, followed by hemiparesis (14.7%) and sensory symptoms (9%). On average, patients consulted 2 sub-specialists before diagnosis, with general practitioners (50%) and ophthalmologists (41%) being the most common. The average EDSS score was 3.4. Vitamin D levels were measured in 12 patients, with an average of 21.35 ng/ml. Of the patients, 35% were on disease-modifying therapies, with 92% on ocrelizumab and 8% on rituximab.
Among NMO/NMOSD patients, 76.5% were female, with an average age of 31.0 years. All were of African ancestry, and 59% had a positive aquaporin-4 antibody. The average time from symptom onset to diagnosis was 1.4 years. Paraparesis (35%) was the most common first symptom, followed by optic neuritis (29%) and sensory symptoms (18%). Patients consulted an average of 2 sub-specialists before diagnosis, with general practitioners (53%) and ophthalmologists (24%) being the most common. The average EDSS score was 4.4. All patients were on treatment, with 76.5% on steroids; for steroid-sparing therapy, 53% were on azathioprine, and 29% were on rituximab
Conclusions:
This study highlights diagnostic delays and limited treatment access for MS and NMOSD in Ghana, emphasizing the need for earlier diagnosis and improved access to treatment.

10.1212/WNL.0000000000211482
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